.FLYINGHEAD KEEPING SCORE ON MOBILE SOLUTIONS
.TITLE Mobile clinical data makes a difference
.AUTHOR Dale Troppito and Dawna Patton
.SUMMARY This month’s Keeping Score column continues the Gantry Group’s journey through the intriguing world of mobile healthcare with a Q&A session on mobile charge capture. Read on to find out how MercuryMD’s MData application is changing how healthcare providers access and interact with patient information.
.DEPT
In this month’s Keeping Score column, we’re going to continue our journey through the intriguing world of mobile healthcare. As we discussed in early columns, mobile computing has had the most striking impact on business process evolution and the bottom line in healthcare more than any other industry sector.
MercuryMD, a healthcare-focused software company located in Durham NC, is devoted to helping providers–hospitals, physicians and clinicians–improve clinical workflow and operational efficiencies. Its mission is to facilitate access to health data–any time and any where. In doing so, providers can take more immediate action on the data, thereby improving healthcare responsiveness, healthcare outcomes, and capturing an accurate history of all services provided to patients.
Alan Ying and William Lawson–two doctors challenged by the first-hand experience of having to deal with inaccurate patient data and the manual gathering of information–founded MercuryMD back in 2001. The result of their collaboration was mobile healthcare solution MData.
MData integrates hospital data from existing information systems and securely delivers patient information, such as census lists, demographics, laboratory results, diagnostic reports, medication lists, consults, and other transcribed reports, directly to clinicians’ mobile devices. The company is now expanding its mobile clinical data paradigm to include mobile charge capture. MData Charge Capture is preparing for a full launch to the market.
We conducted an interview with Alan Ying, MercuryMD’s CEO, to learn more about the mobile healthcare market, the daily work challenges faced by providers, and how the MData suite is addressing this sector’s needs. Prior to founding MercuryMD, Alan practiced as a general surgeon at Duke University.
.BREAK_EMAIL To read the interview, you’ll have to click here.
.Q Gantry
What business conditions have driven providers to be interested in mobile charge capture?
.A Ying
There are two types of charge capture, inpatient and outpatient. Physicians cross both worlds; bridging both is a challenge. Charge capture has been around since 1996, but there’s been little evolution. While the desire and demand by providers was there to increase reimbursement and revenue, it never really went anywhere. Everyone was wishing healthcare business process automation would be a success.
However, most providers were still waiting in anticipation of a payback. Of primary importance is the clinical data that physicians must have access to in order to get their work done. Mobile access to comprehensive clinical data was the critical prerequisite to mobile charge capture being accepted. Mobile clinical data gained market traction in late 2003. Now, as this market expands and matures, mobile charge capture has piqued the interest of providers.
Charges aren’t lost in the physician’s office as they can be in the institutional setting. The physician is typically within 15 feet of a computer, in an office environment that’s been customized and optimized for his/her workflow. However, when the physician leaves the confines of the office–going to a hospital or traveling between hospital and clinic sites–this supportive administrative environment is lost. In these situations, the physician relies upon only paper, a cell phone, and a handheld as a tool bench. The handheld must become the replacement for the office computer.
.Q Gantry
What role have handhelds played in fueling the interest in charge capture solutions?
.A Ying
Mobile devices are commodities–they don’t drive applications per se. Mobile devices really have little influence on the evolution of mobile clinical data; instead the application has driven the adoption of the technology. Cell phones exist because of the application they provide. Mobile access to clinical data is driving providers’ adoption of mobile charge capture solutions. By equipping providers with better and faster access to patient data, providers meet the data accessibility challenge, improving patient care and decreasing medical errors.
.Q Gantry
Prior to the emergence of handhelds, how did providers manage charge capture?
.A Ying
The physician’s office administrator would print out a piece of paper every morning and afternoon for each physician. This piece of paper would include the latest patient census. A set of charge codes would be preprinted on this paper for the physician to check off on each patient. The physician would literally fold up this piece of paper, using it as the sole recording tool during hospital rounds, etc.
The physician would scribble down charge codes next to each patient’s name on the list as services were provided, along with resulting diagnoses, which could generate the scheduling of additional clinical procedures and tests. If there were a consult the previous night, and the data didn’t get logged on this piece of paper, the physician would need to go back to the office to retrieve the missing clinical data and then modify the charge codes. It was a very manual process.
.Q Gantry
What are the barriers that MercuryMD encounters to convincing providers to invest in Charge Capture?
.A Ying
We generally don’t run into problems. Our customers are primarily hospitals; our users are physicians. If a hospital is interested in providing clinical data via our solution, they’ll make the investment. The investment is actually quite small in comparison to the business gain. Providing mobile access to clinical data drives demand for mobile charge capture. A physician can’t code unless they have all the clinical data at hand. It’s great now that we have mobile clinical data access; we can finally do charge capture.
.Q Gantry
When was MData first released?
.A Ying
We began our corporate mission back in September 2001. We commercially deployed MData in January 2002.
.Q Gantry
Why did you feel this was the right time to release a mobile charge capture solution?
.A Ying
Originally, our core product focused only on mobile clinical data delivery. With over 200 hospitals using MData today, MercuryMD has the largest penetration of hospitals in the industry, and this market is growing rapidly. In 2003, an estimated 419 U.S. hospitals had mobile healthcare solutions operational within their enterprise, and the market for these systems is projected to grow significantly to include 2,047 hospitals by 2007.
With MData fully entrenched in the market, MercuryMD is now releasing MData Charge Capture. This new product was released the first quarter of 2005, with general availability planned for second quarter 2005.
.Q Gantry
What were the critical design goals for MData? What problems were you trying to solve for your target market?
.A Ying
Hospitals spend the money on the mobile healthcare solutions. The overriding need of hospitals is to satisfy their physician networks. Physicians select which hospitals and clinics they wish to be affiliated with. In turn, the physicians drive the patient flow to those hospitals. The goal is to make the process of getting clinical data and performing charge capture simple.
MercuryMD had mobile clinical data down. We needed to make mobile charge capture equally easy to use. To achieve high physician adoption, we needed to provide high value for the investment, measured in physician time and real estate on the handheld. Basically, our motto was "keep it simple!"
.Q Gantry
Rumor has it that physicians do not readily adopt handhelds and mobile charge capture solutions into their daily routines. What has been MercuryMD’s experience?
.A Ying
Try an MData demo! You’ll see bigger buttons, bigger font, an intuitive user interface and screen layout. MData supports access to data via infrared, wireless, and cellular networks. MData is also flexible, supporting both Palm OS and Pocket PC handhelds. Make the solution easy to use, and people will use it.
Over 10% of our user base is comprised of physicians who don’t use a computer and don’t do email. The excuse that doctors have trouble with computers and software solutions because they’re technophobes is a cop out. Physicians care about time.
Poor solution design means that it takes more time to use the solution. As a physician, more time spent dealing with difficult technology means that I see fewer patients. As a result, I stop using the solution. If I gain more time, I use the solutions. It’s not the technology; it’s not the doctors. It’s the design of the mobile applications that make the difference in provider adoption. Usability is the key.
.Q Gantry
What value do you believe MData brings to physicians?
.A Ying
MData makes physicians’ professional lives easier. For example, let’s say a physician gets paged about a patient in the hospital. Normally, the physician would need to sit on the phone while the nurse fetches and reads lab results, patient data, meds, etc. The alternative is for the physician to go home and log on to the Internet. This takes 30 minutes at least.
Now with MData, when the physician gets the page, the data is right there at his/her fingertips. The physician makes a call and gives the order. This process only takes 2 minutes.
Look at the numbers: if a physician gets two pages a night, five pages a day, quality of life goes down simply because you don’t have access to the information you need to do your job. As a physician, you want to take care of the patient, and you want to avoid making bad decisions–you want to avoid malpractice.
MData gives time back to the physician, thereby improving quality of life, allowing them to serve more patients, delivering more responsive care, and making more money. First and foremost, save time and make lives easier. Distilling it down, mobile access to clinical data earns higher physician satisfaction–which for hospitals is good for business.
Having mobile access to clinical data enables mobile charge capture. It’s a necessary prerequisite.
.Q Gantry
What value do you believe MData brings to hospitals?
.A Ying
MData drives physician satisfaction, the heart of the hospital’s business. If the physician is satisfied, the physician refers patients to the hospital. It’s as simple as that.
Physician satisfaction isn’t motivated by the latest clinical decision support data, it’s mobile clinical data that’s easy to use that gets them excited. It’s a tangible driver–strategically, operationally, tactically: it’s happy docs that make the hospital’s business successful.
.Q Gantry
How are providers measuring the bottom line success, i.e. the ROI (return on investment) of mobile charge capture solutions?
.A Ying
There are plenty of practical group studies on charge capture. These studies show cash flow increases, total encounter increases, etc. The return is easy to measure. While these ROI assessments are very compelling, they’ve been around for 10 years. However, charge capture has only recently taken off in the market. Mobile charge capture is definitely linked to mobile clinical data.
Most ROI questions about mobile clinical data and mobile charge capture have gone away. It’s accepted that physicians’ satisfaction is good for the hospital’s business. Believe it or not, in the past there actually used to be a position at hospitals titled VP of electricity. This individual was responsible for evaluating the merits of the application of electricity to healthcare practices and procedures.
The title, of course, no longer exists. Buy why? Electricity is now deemed as a necessary utility. No one asks for ROI of electricity, running water, or phone service. All are simply considered mandatory utilities. Mobile access to clinical data is now being considered such a necessary utility. It’s the cost of doing business in health care, based upon subjective metrics.
.Q Gantry
Based upon your customers’ deployment experiences, what’s the typical payback horizon for MData?
.A Ying
Customers are measuring payback. MercuryMD is the #1 numerically-rated vendor based on customer satisfaction feedback as determined by the largest vendor organization, KLAS Enterprise.
If the hospital already has MData for mobile clinical data, buying charge capture yields a near immediate payback–within 30 days. Over 80% of hospitals now say that mobile clinical data is a core product within their technology plans.
However, physicians don’t care what hospitals want. Hospitals are satisfied because the doctors are satisfied with their workflow support. Payback, or ROI, is specifically suited to charge capture. There are no less than 50 studies that measure charge capture application ROI. But mobile charge capture is only an application; clinical data is a core technology.
When asked if mobile clinical data solutions are worth the money, 96% of enabled hospitals say, "Yes." It’s all about the cart before the horse. The market wasn’t suited for mobile charge capture because mobile clinical data wasn’t adequately entrenched. Now, the market has a much higher penetration of mobile clinical data systems, and mobile charge capture is being readily adopted.
.Q Gantry
Looking at few of your customers, what areas and levels of payback have your customers achieved?
.A Ying
Everyone likes to quantify a return. One hospital did a study to measure the increase of computerized physician order entry. While this isn’t based in mobility, it is very important for hospitals across the country. Unfortunately, physician use of the hospital’s system was infrequent. Within six months after this hospital deployed MData to enable mobile clinical data access, the hospital tracked 11,000 orders placed per month using the system. This hospital didn’t quantify in dollars or timesavings, but in achieving its core mission.
Another customer, Baptist Health in Little Rock, AK, quantified time saved in terms of nurses not having to track down and check clinical data information for its physician network. Post MData mobile clinical data deployment, Baptist Health saved $275k per year because the nurses avoided spending 25% of their time chasing down data that physicians didn’t have. Physicians had immediate access to this clinical data without the nurse being involved in the process.
.Q Gantry
What MData attributes enable the achievement of this payback level?
.A Ying
Ease of use by physicians. MData achieves a cost-effective, rapid delivery for physicians. Deployment rollout within a hospital is typically 2-3 months. We’ve even had cases where the rollout went as fast as one month. The hospital must first purchase and integrate MData into its system. For our solution, a physician can’t simply download the personal solution from the Internet. Other charge capture applications on the market have been largely personally downloaded off the Internet. Such applications are not tied into anything, and that’s why charge capture hasn’t taken off–until now.
.Q Gantry
How do you believe the MData solution differentiates from other mobile charge capture solutions on the market?
.A Ying
The key differentiation is that our charge capture application integrates into the clinical data. Plus, it’s really simple to use and works within the user’s workflow; MData doesn’t require a physician to do something outside of his/her normal routine. Remember the daily patient census printed up on a piece of paper that the physician folded up and stuffed in a pocket? Now, with MData Charge Capture, the patient information instantly appears. While looking at this patient data, the physician hits the $ button and is immediately taken to a charge capture screen. Right then and there the charge occurs–completely integrated into the clinical data.
.Q Gantry
Handhelds evolve rapidly. How do you see MercuryMD taking advantage of these new device capabilities?
.A Ying
MData is operating system independent, available on Palm OS and Pocket PC handhelds. Our software runs identically on both operating systems, using the same solution code base. As more phones become equipped to run these operating systems, smartphones will become increasingly appropriate for mobile clinical data and mobile charge capture solutions.
MData employs encryption and compression technology to move data securely and quickly over cellular networks. As cellular network bandwidth increases, it will also be possible to accurately present clinical images on a mobile device. We feel MercuryMD is set up well to respond to the proliferation of smartphones, which is currently on a steep month-to-month growth curve. Six months ago, less than 1% of physicians used smartphones; today fewer than 10% of physicians are now using smartphones instead of handhelds.
.H1 So what do customers have to say?
Virginia Hospital Center, located in Arlington VA, needed to solve a problem: the hospital didn’t have sufficient terminals at nurse stations for physicians to easily sign on and access clinical data. Selected for its strong security structure and intuitive interface, MData is now installed at the hospital.
Today, over 40% of physicians affiliated with the hospital access clinical data using a handheld and MData. Physicians can access clinical data immediately upon arrival at the hospital via infrared synch stations or wireless network. This capability has proven particularly useful for physicians who are on-call for another physician’s patients. They can immediately become apprised of the patient’s health history and progress.
According to Arlowen Raygor, Director of Clinical Systems at Virginia Hospital Center, "MData saves our physicians time by giving them access to the data they need quickly. MData has increased physician satisfaction and has contributed to giving Virginia Hospital Center a competitive edge in our market."
While we thoroughly enjoy pontificating on our personally selected topics regarding Mobile Enterprise Solutions, we’d like to establish an interactive relationship with our reading audience. Monologues are not us! We’d like to invite you to send your questions, opinions, and topic suggestions on mobile enterprise solution value delivery to dtroppito@computingunplugged.com. We’ll do our very best to respond expeditiously in our upcoming columns. Looking forward to hearing from you!
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.H1 Product availability and resources
For more information on MData MercuryMD, visit http://www.mercurymd.com.
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.BIO
